Chapter 76 Testicular tumors

Question 1

Neoplasms of the testis comprise a morphologically and clinically diverse group of tumors, more than 95% of which are germ cell tumors (GCTs).”

Answer 1

High-yield: GCTs = 95% of testicular tumors.

Question 2

“GCTs are broadly categorized as seminoma and nonseminoma (NSGCT) because of differences in natural history and treatment.”

Answer 2

seminoma vs. NSGCT (includes embryonal carcinoma, yolk sac tumor, teratoma, choriocarcinoma).

Question 3

What is the disease-free survival for low-volume stage II NSGCT treated with primary RPLND?

Answer 3

60-80

Question 4

most common solid malignancy in young men (20–40 y).

Answer 4

“GCT is a relatively rare malignancy, accounting for 1% to 2% of cancers among adult males in the US

Question 5

Approximately 95% of GCTs arise in the testis, and 5% are extragonadal in origin.”

Answer 5

: ~45%.

Question 6

What is the relative risk (RR) of testicular cancer with cryptorchidism?

Answer 6

RR 4-6, drops to 2-3 if orchiopexy before puberty

Question 7

What is the risk of contralateral testis cancer after GCT?

Answer 7

12× risk; ~2% cumulative incidence at 15 years.

Question 8

What three tumors do not arise from GCNIS?

Answer 8

Prepubertal yst, prepubertal teratoma, spermatocytic tumor

Question 9

What hallmark genetic abnormality is seen in ~70–80% of postpubertal GCTs?

Answer 9

Isochrome 12p

Question 10

What environmental factors are suspected in rising GCT rates?

Answer 10

Prenatal endocrine disruptors, birth cohort effect (still under investigation).

Question 11

What is the peak age range for testicular cancer incidence?

Answer 11

25-35

Question 12

What is the birth cohort effect in testicular cancer, and what environmental factors are suspected to contribute?

Answer 12

The birth cohort effect refers to rising testicular cancer rates seen in men born in more recent decades, suggesting environmental changes over time.
Suspected environmental factors include prenatal exposure to endocrine-disrupting chemicals (e.g., environmental estrogens, PCBs), which may impair fetal germ cell development and increase GCT risk.

Question 13

What tumor shows clear cytoplasm, central nuclei, and fibrous septa with lymphocytes?

Answer 13

A: Seminoma

Question 14

Which tumor shows primitive epithelial cells with indistinct borders, hemorrhage, necrosis, and high mitotic rate?

Answer 14

A: Embryonal carcinoma

Question 15

Which tumor shows both cytotrophoblast and syncytiotrophoblast cells, high β-hCG, and early hematogenous spread?

Answer 15

Choriocarcinoma